Medical benefits of the placebo

Voltaire, the French philosopher and writer, once remarked, "The art of medicine consists in amusing the patient while nature heals the disease." North Americans spend millions of dollars on medication. However, it's often a waste of money when a dummy pill can cure a variety of ailments.

Dr. Ian Paul, assistant professor of pediatrics at Penn State Children's Hospital, Hershey, Pa., reports this interesting finding in the medical journal Pediatrics. His studies show that giving your child a glass of water is equally as effective in relieving troublesome nighttime coughs as expensive over-the-counter medications.

The majority of cough syrups such as those in the best-selling brands Robitussin and Benylin DM have dextromethorphan as the active ingredient. Its purpose is to clear the throat of phlegm. Other cough syrups contain an antihistamine, diphenhydramine, to decrease swelling in the respiratory tract.

Dr. Paul's study involved 100 children with a chronic couch of three days duration due to an upper respiratory infection. Thirty minutes before bedtime, one group was given a syrup containing dextromethorphan, another group syrup with diphenhydramine and the rest a placebo syrup.

Astonishingly, those who received the flavoured water showed the best results! Expectation is a powerful weapon. The more you believe you will benefit from the medication, the more likely this will happen.

Dr. Henry Beecher, late professor of anesthesiology at Harvard Medical School, stunned the medical world in 1955 when he published The Powerful Placebo. Beecher argued that to determine the effectiveness of drugs they should all be tested by "double-blind studies," in effect, whether the drug worked any better than a placebo.

Physicians were appalled to find that following such studies, 650 time-honoured drugs were pulled off the market. The gullible public and many doctors had believed TV ads claiming that the drugs were effective.

NOT NEW THERAPY

Placebo therapy is not new. Long before TV, crocodile dung, oil of ants, asses hooves and moss scraped from the skull of a victim of violent death were prescribed to treat a variety of medical problems, with some success.

Not all placebos are pills or sterile water. Forty-five years ago surgeons in Seattle treated anginal pain by tying off the internal mammary arteries to increase blood flow to the heart's muscle. Ninety percent of patients reported it helpful. But when surgeons merely did a skin incision, and nothing else, the results were equally effective!

Later, in 1978, Danish surgeons treated Meniere's Disease by the standard operation. Then a similar number were treated by only a skin incision. They too were surprised that the sham surgery cured the same number of patients.

But here's one that is even more shocking. Two hundred and forty-six men out of the 613 who received the placebo suffered adverse reactions. In fact, in 40 men, the reaction was so severe that the dummy pill had to be stopped.

Researchers at the University of Oklahoma had a frightening experience. They prescribed a placebo to a man suffering from anxiety. Shortly after the medication was given, the patient's blood pressure dropped, his skin became clammy and he collapsed.

In other studies, untrained college professors achieved similar results to high priced psychotherapists when treating psychological problems in students. And asthmatics can often breathe better when given phony bronchodilators.

As a sufferer of recurring plantar warts, one study particularly interested me. Doctors painted plantar warts with a brightly coloured dye. The patients were then told the warts would disappear once the dye had worn off. The results were incredibly successful.

Obviously there's great debate about the ethics of placebo treatment. But I'll leave this argument to philosophers. I'm going out to buy the coloured water and I'll report the results in a later column.